ML Blettel MD

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

MD15147 Issued in OR

Legal business name

ML BLETTEL MD

Practice address

5559 SW 85TH Ave
Portland, OR 97225-1709

Phone

(503) 894-9464

Fax

(503) 926-8397

NPI assigned

Jan 17, 2012

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Milton Louis Blettel, M.D.

Title

Member Manager

Phone

(503) 894-9464

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1326758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1336953600000",
    "number": "1083985428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5559 SW 85TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972251709",
            "telephone_number": "503-894-9464",
            "fax_number": "503-926-8397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5559 SW 85TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972251709",
            "telephone_number": "503-894-9464",
            "fax_number": "503-926-8397"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ML BLETTEL MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-17",
        "last_updated": "2012-05-14",
        "status": "A",
        "authorized_official_last_name": "BLETTEL",
        "authorized_official_first_name": "MILTON",
        "authorized_official_middle_name": "LOUIS",
        "authorized_official_title_or_position": "MEMBER MANAGER",
        "authorized_official_telephone_number": "503-894-9464",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "OR",
            "license": "MD15147",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "078444",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Catherine Mizell, REGISTERED NURSE
• Adam Mizgajski, MD
• Colin Matthew Mizuo, DPM
• Aoi N Mizushima, MD
• Mja Health Services, Inc.
• MLB Nutrition & Wellness, LLC
• MLC Urgent Care, LLC
• Riziki Mmuhongelwa
• Jeanette Amisi Mmunga
• Peter Emedi Mmunga

• Primary Care Clinic/Center in Portland, OR
• Providers in Portland, OR by specialty
• Primary Care Clinic/Center in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.